Promoting Excellence : Quality Assurance Good Death Tool

Cardinal Glennon Footprints: Quality Assurance Good Death Tool

This is a survey used to assess a clinician's perception of care provided to a child enrolled in the Footprints pediatric palliative care program.

Evaluation Tools - Satisfaction/Perception of Care

SSM Cardinal Glennon Children's Hospital
1465 South Grand Boulevard
St. Louis, MO 63104

Mary Ann Collins, MHA
[email protected]

How the grantee used this instrument:
This questionnaire is mailed as soon as possible after the child's death to all key health care professionals involved in caring for the child.

pediatrics, perception of care, patient experience, care review, provider satisfaction

To use this tool:
You may print and copy this tool for your own use from this site. Please credit source.

Developed specifically for this project by the project team. Copyright © 2001 Footprints at SSM Cardinal Glennon Children's Hospital. All Rights Reserved.

To view this tool:
To view the tool in your browser left-click on the link below or to download to your computer right-click on the link.
pdf PDF 125 KB / 4 pages

Posted June 30, 2003

SSM Cardinal Glennon Children's Hospital overview page

# GLEN11, type:satisfaction/perception_care

Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying persons and their families. Visit for more resources.

Promoting Excellence logo and link to home page